Provider First Line Business Practice Location Address:
12510 N WELTY RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268-1757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
223-250-6504
Provider Business Practice Location Address Fax Number:
717-788-3173
Provider Enumeration Date:
05/21/2026